Cocaine Use Disorder

Definition

Cocaine use disorder is when the use of cocaine harms a person’s health or social functioning, or when a person becomes dependent on cocaine. The powdered form of cocaine can be snorted or dissolved in water and injected. Crack is cocaine in a rock crystal form. It can be heated so its vapors can be smoked.

Cocaine use disorder is treatable, but it takes hard work.

Causes

Cocaine stimulates the brain to release large amounts of the hormone dopamine. Dopamine results in the euphoria commonly reported by cocaine abusers. As a person continues to use cocaine, a tolerance is developed. This means that higher doses and more frequent use are needed to maintain the euphoria.

Release of Dopamine in the Brain

The dopamine connecting to the receptors causes a euphoric feeling. This occurs naturally, but cocaine causes an exaggerated response that can lead to addiction.

When a cocaine user stops using abruptly, a crash or withdrawal occurs. This results in an extremely strong craving for more cocaine. It also results in fatigue, loss of pleasure in life,
depression,
anxiety, irritability, suicidal thoughts, and sometimes paranoia. These withdrawal symptoms often prompt the user to seek more cocaine.

Risk Factors

Cocaine use disorder is more common in young men and in those aged 18-25 years. However, cocaine use disorder can occur in anyone at any age.

Diagnosis

The doctor will ask about symptoms and medical history. A physical exam will be done. The doctor will ask specific questions about cocaine use. Questions will include the length and frequency of use.

Treatment

Treatment programs may be inpatient or outpatient and may:

Require that cocaine use has been stopped

Involve a detoxification program

Medications

There are currently no medications to specifically treat cocaine use disorder.
Treatment with medication focuses on the symptoms of euphoria and craving. Medications that have shown some promise include:

Modafinil—wakefulness-promoting agent

N-acetylcysteine

Topiramate—seizure medication

Disulfiram

Agonist replacement therapy

Baclofen

Antidepressants—may be helpful for people in the early stages of stopping cocaine use

Behavioral Therapy

Behavioral therapies to help people quit using cocaine are often the only available, effective treatment for cocaine use disorder. Therapies include contingency management. With this program, people receive positive rewards for staying in treatment and remaining cocaine-free. Also,
cognitive behavioral therapy
helps people to learn how to abstain and remain abstinent from cocaine.

Rehabilitation Programs

In rehab programs, people with cocaine use disorder stay in a controlled environment for 6-12 months. During this time, they may receive vocational rehab and other support to prepare them to return to society.

Prevention

The best way to prevent cocaine use disorder is to never use cocaine. It is highly addictive and illegal.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.